不同社会经济地位社区诊所的健康素养与互联网接入情况比较研究。
Comparative study of different SES neighborhood clinics for health literacy and internet access.
作者信息
Livingood William C, Bautista Maria A B, Smotherman Carmen, Azueta Daidre, Coleman Jeremy, Grewal Reetu, Stewart Eric, Orlando Lori A, Scuderi Christopher
机构信息
Office of Research Affairs, University of Florida College of Medicine-Jacksonville, USA.
Department of Community Health and Family Medicine, University of Florida College of Medicine-Jacksonville, USA.
出版信息
Digit Health. 2022 Sep 4;8:20552076221123715. doi: 10.1177/20552076221123715. eCollection 2022 Jan-Dec.
BACKGROUND
As healthcare services are increasingly dependent on patient utilization of technology to effectively deliver services, the digital divide has the potential to exacerbate health disparities if health literacy and internet access present formidable barriers to patient use of technology.
METHODS
We examined the differences in health literacy and internet access between lower and upper SES neighborhood primary-care clinics in Northeast Florida. The REALM-SF for health literacy was used to assess health literacy and census survey questions were used to assess internet and technology access, during the Fall, 2020. The clinics were affiliated with a safety-net hospital in a major city in Southeastern U.S.
RESULTS
Analysis of key demographic data confirmed that the responding patients from economically disadvantaged neighborhood clinics resided in economically disadvantaged zip codes (307 responding patients lived in lower SES neighborhoods) and did have lower education levels (3% of the patients from Upper SES clinics had 11 grade or lower education, compared to 21%-29% of patients from Lower SES clinics). Patient health literacy significantly differed between clinics located in economically disadvantaged neighborhoods and clinics located in more affluent neighborhoods, with Upper SES clinics being 2.4 times more likely to have 9th grade or higher reading level. Access to internet technology was also higher in the Upper SES clinics, with 59% of respondents from Upper SES clinics versus 32%-40% from Lower SES clinics owning a computer or an IPAD.
CONCLUSION
Results of this study have important implications for patient-engaged use of digital technology for health. Healthcare and public health clinics should be aware of the difference in health literacy and internet access when implementing technology-based services, so that advances in medicine, including precision medicine and telehealth, can be disseminated and implemented with broad populations, including disadvantaged groups.
背景
由于医疗保健服务越来越依赖患者对技术的利用来有效提供服务，如果健康素养和互联网接入对患者使用技术构成巨大障碍，数字鸿沟有可能加剧健康差距。
方法
我们研究了佛罗里达州东北部社会经济地位较低和较高社区的初级保健诊所之间在健康素养和互联网接入方面的差异。2020年秋季，使用健康素养的REALM-SF来评估健康素养，并使用人口普查调查问卷来评估互联网和技术接入情况。这些诊所隶属于美国东南部一个大城市的安全网医院。
结果
关键人口统计数据分析证实，来自经济弱势社区诊所的应答患者居住在经济弱势邮政编码地区（307名应答患者居住在社会经济地位较低的社区），且教育水平较低（社会经济地位较高诊所的患者中有3%的人受教育程度为11年级或更低，而社会经济地位较低诊所的患者这一比例为21%-29%）。位于经济弱势社区的诊所和位于较富裕社区的诊所的患者健康素养存在显著差异，社会经济地位较高的诊所患者达到9年级或更高阅读水平的可能性是前者的2.4倍。社会经济地位较高的诊所的互联网技术接入率也更高，社会经济地位较高诊所的59%的受访者拥有电脑或iPad，而社会经济地位较低诊所的这一比例为32%-40%。
结论
本研究结果对患者参与使用数字技术促进健康具有重要意义。医疗保健和公共卫生诊所在实施基于技术的服务时应意识到健康素养和互联网接入方面的差异，以便包括精准医学和远程医疗在内的医学进步能够在包括弱势群体在内的广大人群中得到传播和实施。
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